In In-Person Meeting January 10-11, 2019 Welcome 2 MAC Scorecard - PowerPoint PPT Presentation

Medicaid and CHIP (M (MAC) ) Scorecard Committee In In-Person Meeting January 10-11, 2019

Welcome 2

MAC Scorecard NQF Project Team ▪ Debjani Mukherjee, Senior Director ▪ Ashlie Wilbon, Senior Director ▪ Shaconna Gorham, Senior Project Manager ▪ Miranda Kuwahara, Project Manager ▪ Jordan Hirsch, Project Analyst 3

Welcome ▪ Restrooms  Exit main conference area, past elevators, on right. ▪ Breaks  10:40am – 15 minutes  12:45pm – Lunch provided by NQF ▪ Laptops and cell phones  Wi-Fi network » User name: guest » Password: NQFguest  Please mute your cell phone during the meeting ▪ Public comment period  Dedicated times for public comment  Comment via chat box at any time and comments will be shared during dedicated times 4

Review of Meeting Objectives 5

Meeting Objectives Identify priority measure gaps and gap areas Identify measures for potential addition that address identified gaps or measures for removal Consider states’ experiences implementing the Medicaid Child and Adult Core Set measures 6

Introductions of Committee Members and Disclosures of Interest 7

MAC Scorecard Committee Membership Committee Chairs (voting) Harold Pincus, MD Richard Antonelli, MD Organizational Members (voting) Organizational Representative Aetna Medicaid Stephanie A. Whyte MD, MBA, CHCQM, CHIE American Association on Health and Disability Clarke Ross, DPA American Association of Nurse Practitioners (AANP) Sue Kendig, JD, WHNP-BC, FAAPN American Nurses Association (ANA) Rhonda Anderson, RN American Occupational Therapy Association Joy Hammel, PhD Anthem Indiana Medicaid Carla Zachodni, RN, MBA, CPHQ Association for Community Affiliated Plans (ACAP) Enrique Martinez-Vidal, MPP Children's Hospital Association (CHA) Sally Turbyville, DRPH, MS, MA Human Services Research Institute Julie Bershadsky, PhD Intermountain Health Josh Romney, MD Elizabeth Matney National Association of Medicaid Directors (NAMD) Sarah Brooks National Association of Pediatric Nurse Practitioners (NAPNAP) Shayna Dahan, BSN, RN, MSN, CPNP, PMHS National Partnership for Women & Families Carol Sakala, PhD, MSPH Ohio Department of Medicaid Mary Applegate, MD 8

MAC Scorecard Committee Membership Individual Subject Matter Experts (voting) Kim Elliott, PhD, CPHQ SreyRam Kuy, MD, MHS, FACS Julia Logan, MD Lisa Patton, PhD Judy Zerzan, MD Marissa Schlaifer, RPh, MS Kamala Allen, MHS David Einzig, MD Amy Houtrow, MD, PhD, MPH David Kelley, MD, MPA Stephen Lawless, BS, MD, MBA, FAAP, FCCM, FSMB Jill Morrow-Gorton, MD, MBA Elisabeth Okrant, MPH, MSP, PhD Kenneth Schellhase, MD, MPH Jeff Schiff, MD, MBA Lindsay Cogan, PhD 9

MAC Scorecard Committee Membership Federal Government Members (non-voting) Agency Agency Representative Agency for Healthcare Research and Quality (AHRQ) Kamila Mistry, PhD, MPH Substance Abuse and Mental Health Services Laura Jacobus-Kantor, PhD Administration Centers for Medicare & Medicaid Services (CMS) Marsha Smith, MD, MPH, FAAP Health Resources and Services Administration Suma Nair, MS, RD 10

Measure Selection Criteria Overv rview 11

Committee Overv rview and Key Points fr from Staff f Review of f Scorecard 12

Charge of f th the MAC Scorecard Committee The Scorecard Committee is charged with exploring the existing Child and Adult Core Set measures and recommending measures for removal from the Scorecard or recommending measures for addition to the Scorecard that can be used to support the MAC Scorecard’s state health system performance pillar.  Potential measures for addition to the Scorecard will focus on addressing the use and usefulness of measure implementation and reporting. 13

MAC Scorecard 1.0 Promote Effective Communication and Coordination of Care Domain NQF 0576 Follow-Up After Hospitalization for Mental Illness *NQF 1517 Prenatal and Postpartum Care: Postpartum Care Make Care Safer by Reducing Harm Caused in the Delivery of Care Domain Use of Multiple Concurrent Antipsychotics: Ages 1-17 Promote Effective Prevention & Treatment of Chronic Diseases Domain NQF 1392 Well-Child Visits: First 15 Months NQF 1516 Well-Child Visits: Ages 3-6 Adolescent Well-Care Visits: Ages 12-21 NQF 1407 Immunizations for Adolescents: Age 13 Percentage of Eligibles Who Received Preventive Dental Services: Ages 1-20 NQF 2940 Use of Opioids at High Dosage in Persons Without Cancer NQF 0004 Initiation & Engagement of Alcohol & Other Drug Dependence Treatment: Age 18 & Older NQF 0018 Controlling High Blood Pressure: Ages 18-85 Strengthen Engagement in Care Domain Getting Care Quickly (CAHPS) Getting Needed Care (CAHPS) Make Care Affordable Domain NQF 0272 PQI 01: Diabetes Short-Term Complications Admission Rate *Endorsement removed 14

MAC C Sc Scorecard Propertie ies: Pil illa lar One Measure Ch Characteris istic ics # of Measures MAC Scorecard Characteristics (n = 13) ▪ Insert table here Medicaid and CHIP Child Beneficiaries 6 Medicaid & CHIP Population Medicaid Adult Beneficiaries 7 Endorsed 8 NQF Endorsement Status Not Endorsed 5 Structure 0 Process 8 Measure Type Outcome 2 Patient Experience of Care 1 Administrative Claims 10 Electronic Clinical Data 6 Data Collection Method* eMeasure Available 0 Survey Data 1 *Data not mutually exclusive Note: Measure Type and Data Collection Method data unavailable for the following measures: Percentage of Eligibles Who Received Preventive Dental Services: Ages 1-20 and Adolescent Well-Care Visits: Ages 12-21 15

Number of of States Reporting th the Medicaid id Ch Child ild Co Core Set t Measures, FFY2 Y2017 PDENT: Percentage of Eligibles who Received Preventive… W34: Well-Child Visits in the Third, Fourth, Fifth, and Sixth… AWC: Adolescent Well-Care Visits W15: Well-Child Visits in the First 15 Months of Life CAP: Child and Adolescent's Access to Primary Care Practitioners AMB: Ambulatory Care: Emergency Department (ED) Visits CHL: Chlamydia Screening in Women Ages 16-20 FUH: Follow-Up After Hospitalization for Mental Illness: Ages… CIS: Childhood Immunization Status IMA: Immunization Status for Adolescents MMA: Medication Management for People with Asthma CAHPS: Consumer Assessment of healthcare Providers and… PPC: Timeliness of Prenatal Care BMI: Body Mass Index Assessment: 3-17 Years ADD: Follow-Up Care for Children Newly Prescribed Attention-… Use of Multiple Concurrent Antipsychotics in Children and… FPC: Frequency of Ongoing Prenatal Care DQA: Prevention: Dental Sealants for 6-9 Year Old Children at… LBW: Live Births Weighing Less than 2,500 Grams DEV: Developmental Screening in the First Three Years of Life Use of First-Line Psychosocial Care for Children and… Contraceptive Care: Postpartum Women Ages 15-20 PC02: Cesarean Section BHRA: Behavioral Health Risk Assessment (for Pregnant Women) Audiological Evaluation No Later than 3 Months of Age Child and Adolescent Major Depressive Disorder: Suicide Risk… 0 10 20 30 40 50 60 Denotes inclusion in Scorecard Sources: Mathematica analysis of MACPro reports for the FFY 2017 reporting cycle 16 Notes: The term “states” includes the 50 states and the District of Columbia.

Number of of States Reporting th the Medicaid id Adult lt Co Core Set t Measures, FFY2 Y2017 Follow-Up After Hospitalization for Mental Illness: Aged 21 and Older Chlamydia Screening in Women Ages 21-24 Cervical Cancer Screening Breast Cancer Screening Prenatal and Postpartum Care: Postpartum Care Comprehensive Diavetes Care: Hemoglobin A1c Testing Annual Minitoring for Patients on Persistent Medications Antidepressant Medication Management Adult Body Mass Index Assessment Adherence to Antipsychotics for Individuals with Schizophrenia Initiation and Engagement of Alcohol and Other Drug Dependence… Diabetes Screening for People with Schizophrenia or Bipolar Disorder… PQI 01: Diabetes Short-Term Complications Admission Rate Comprehensive Diabetes Care: Hemoglobin A1c Poor Control (>9.0%) CAHPS Health Plan Survery 5.0H, Adult Version (Medicaid) PQI 15: Asthma In Younger Adults Admission Rate Plan All-Cause Readmissions PQI 08: Heart Failure Admission Rate PQI 05: COPD or Asthma in Older Adults Admission Rate Controlling High Blood Pressure Use of Opioids at High Dosage in Persons Without Cancer Contraceptive Care: Postpartum Women Ages 21-44 Medical Assistance With Smoking and Tobacco Use Cessation Flu Vaccinations for Adults Ages 18-64 Follow-up After ED Visit for Mental Illness or AOD Dependence PC-01: Elective Delivery Screening for Clinical Depression and Follow-Up Plan HIV Viral Load Suppression PC-03: Antenatal Steroids Diabetes Care for People with Serious Mental Illness: Hemoglobin A1c… 0 5 10 15 20 25 30 35 40 45 50 17

Measure Review Process ▪ Staff compiled Adult and Child Core Set measures into an Excel spreadsheet, providing measure specification information ▪ Committee members submitted measure recommendations from the universe of measures included in the Excel spreadsheet ▪ Staff completed a preliminary analysis algorithm on each recommended measure ▪ Only measures recommended for review by Committee members will be considered ▪ Measure specifications and preliminary analysis results will be shared during the in-person meeting via an electronic discussion guide 18